{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T20:42:31Z","timestamp":1793479351634,"version":"4.5.0"},"reference-count":46,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T00:00:00Z","timestamp":1655164800000},"content-version":"unspecified","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2022,5,21]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The crystal-induced calcium pyrophosphate deposition disease (CPPD) clinically appearing as pseudogout differs from the mere radiographic finding of chondrocalcinosis (CC) but may cause symptoms resembling rheumatoid arthritis (RA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To study the prevalence of CPPD and CC in rheumatic diseases focusing on differences between seropositive and seronegative RA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and methods<\/jats:title>\n                  <jats:p>In a retrospective study design, we analysed records and radiographs of consecutive new patients presenting to our centre between January 2017 and May 2020. 503 patients were identified based on expert diagnoses: 181 with CPPD, 262 with RA, 142 seropositive (54.2%) and 120 seronegative RA, gout (n=30) and polymyalgia rheumatica (n=30), mean symptom duration &lt;1\u2009year in almost all patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The majority of patients had only one rheumatological diagnosis (86.9%). Most patients with CPPD (92.6%) had radiographic CC, primarily in the wrists. The prevalence of CC was higher in seronegative (32.3%) than in seropositive RA (16.6%), respectively (p&lt;0.001). Patients with CPPD were older (p&lt;0.001) and had acute attacks more frequently than patients with RA (p&lt;0.001), who had symmetric arthritis more often (p=0.007). The distribution pattern of osteoarthritic changes in radiographs of hands and wrists differs between patients with RA and CPPD. CC was present in more than one joint in 73.3% of patients with CPPD, 9.6% with seropositive and 18.7% with seronegative RA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>CPPD and CC were more frequent in seronegative versus seropositive RA. Symmetry of arthritis and acuteness of attacks differentiated best between CPPD and RA but localisation of joint involvement did not. Co-occurrence of both diseases was frequently observed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2022-002383","type":"journal-article","created":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T11:30:40Z","timestamp":1655206240000},"page":"e002383","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["High prevalence of chondrocalcinosis and frequent comorbidity with calcium pyrophosphate deposition disease in patients with seronegative rheumatoid arthritis"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6337-0223","authenticated-orcid":false,"given":"Martin","family":"Krekeler","sequence":"first","affiliation":[{"name":"Rheumazentrum Ruhrgebiet, Ruhr Universit\u00e4t Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9475-9362","authenticated-orcid":false,"given":"Xenofon","family":"Baraliakos","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Styliani","family":"Tsiami","sequence":"additional","affiliation":[{"name":"Rheumazentrum Ruhrgebiet, Herne, Germany"},{"name":"Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9156-5095","authenticated-orcid":false,"given":"Juergen","family":"Braun","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,6,14]]},"reference":[{"key":"2025090312425911000_8.2.e002383.1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-56-5-738"},{"key":"2025090312425911000_8.2.e002383.2","doi-asserted-by":"crossref","first-page":"240","DOI":"10.7326\/0003-4819-87-2-240","article-title":"Calcium pyrophosphate dihydrate crystal deposition disease: Nomenclature and diagnostic criteria","volume":"87","author":"McCarty","year":"1977","journal-title":"Ann Intern Med"},{"key":"2025090312425911000_8.2.e002383.3","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.139105"},{"key":"2025090312425911000_8.2.e002383.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2014.01.002"},{"key":"2025090312425911000_8.2.e002383.5","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1007\/s00256-016-2376-9","article-title":"Prevalence of asymptomatic chondrocalcinosis in the pelvis","volume":"45","author":"Stensby","year":"2016","journal-title":"Skeletal Radiol"},{"key":"2025090312425911000_8.2.e002383.6","first-page":"99","article-title":"Prevalence of calcium pyrophosphate deposition disease in a cohort of patients diagnosed with seronegative rheumatoid arthritis","volume":"38","author":"Paalanen","year":"2020","journal-title":"Clin Exp Rheumatol"},{"key":"2025090312425911000_8.2.e002383.7","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/BOR.0000000000000246","article-title":"Calcium pyrophosphate deposition disease: a review of epidemiologic findings","volume":"28","author":"Abhishek","year":"2016","journal-title":"Curr Opin Rheumatol"},{"key":"2025090312425911000_8.2.e002383.8","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-016-0574-z"},{"key":"2025090312425911000_8.2.e002383.9","first-page":"819","article-title":"Prevalence of musculoskeletal conditions in an Italian population sample: results of a regional community-based study. 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Chapter 117 Calcium Pyrophosphate Crystal Deposition Disease, Pseudogout, and Articular Chondrocalcinosis. In: Daniel JMcCarty , ed. Arthritis and allied conditions: a textbook of rheumatology. Philadelphia: Lea and Febiger, 1993: 1337\u201350."},{"key":"2025090312425911000_8.2.e002383.25","doi-asserted-by":"crossref","first-page":"2581","DOI":"10.1007\/s10067-020-05516-3","article-title":"A critical review of the available evidence on the diagnosis and clinical features of CPPD: do we really need imaging?","volume":"40","author":"Filippou","year":"2021","journal-title":"Clin Rheumatol"},{"key":"2025090312425911000_8.2.e002383.26","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2016-000339"},{"key":"2025090312425911000_8.2.e002383.27","doi-asserted-by":"publisher","DOI":"10.1002\/art.27584"},{"key":"2025090312425911000_8.2.e002383.28","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208237"},{"key":"2025090312425911000_8.2.e002383.29","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200329"},{"key":"2025090312425911000_8.2.e002383.30","doi-asserted-by":"publisher","DOI":"10.1136\/ard.55.1.30"},{"key":"2025090312425911000_8.2.e002383.31","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1007\/s10067-005-0082-4","article-title":"CPPD crystal deposition disease in patients with rheumatoid arthritis","volume":"25","author":"Gerster","year":"2006","journal-title":"Clin Rheumatol"},{"key":"2025090312425911000_8.2.e002383.32","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.semarthrit.2017.11.009","article-title":"Concurrence of rheumatoid arthritis and calcium pyrophosphate deposition disease: a case collection and review of the literature","volume":"48","author":"Sabchyshyn","year":"2018","journal-title":"Semin Arthritis Rheum"},{"key":"2025090312425911000_8.2.e002383.33","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s00296-012-2608-9","article-title":"The detection of calcium pyrophosphate crystals in the synovial fluid of patients with rheumatoid arthritis using the cytospin technique: prevalence and clinical correlation","volume":"34","author":"Theiler","year":"2014","journal-title":"Rheumatol Int"},{"key":"2025090312425911000_8.2.e002383.34","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/s00296-015-3376-0","article-title":"The prevalence of monosodium urate and calcium pyrophosphate crystals in synovial fluid from wrist and finger joints","volume":"36","author":"Galozzi","year":"2016","journal-title":"Rheumatol Int"},{"key":"2025090312425911000_8.2.e002383.35","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1007\/s10067-016-3477-5","article-title":"Comorbidity of gout and rheumatoid arthritis in a large population database","volume":"36","author":"Merdler-Rabinowicz","year":"2017","journal-title":"Clin Rheumatol"},{"key":"2025090312425911000_8.2.e002383.36","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.semarthrit.2015.11.014","article-title":"Prevalence of monosodium urate deposits in a population of rheumatoid arthritis patients with hyperuricemia","volume":"45","author":"Petsch","year":"2016","journal-title":"Semin Arthritis Rheum"},{"key":"2025090312425911000_8.2.e002383.37","doi-asserted-by":"crossref","first-page":"annrheumdis-2017-212542","DOI":"10.1136\/annrheumdis-2017-212542","article-title":"Identification of calcium pyrophosphate deposition disease (CPPD) by ultrasound: reliability of the OMERACT definitions in an extended set of joints-an international multiobserver study by the OMERACT calcium pyrophosphate deposition disease ultrasound Subtask force","volume":"77","author":"Filippou","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"2025090312425911000_8.2.e002383.38","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/s00256-019-03343-5","article-title":"Dual-Energy CT in the differentiation of crystal depositions of the wrist: does it have added value?","volume":"49","author":"Ziegeler","year":"2020","journal-title":"Skeletal Radiol"},{"key":"2025090312425911000_8.2.e002383.39","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1002\/art.41569","article-title":"Can dual-energy computed tomography be used to identify early calcium crystal deposition in the knees of patients with calcium pyrophosphate deposition?","volume":"73","author":"Budzik","year":"2021","journal-title":"Arthritis Rheumatol"},{"key":"2025090312425911000_8.2.e002383.40","doi-asserted-by":"crossref","unstructured":"Tedeschi SK , Pascart T , Latourte A , et al . Identifying potential classification criteria for calcium pyrophosphate deposition disease (CPPD): item generation and item reduction. Arthritis Care Res.doi:10.1002\/acr.24619","DOI":"10.1002\/acr.24619"},{"key":"2025090312425911000_8.2.e002383.41","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.semarthrit.2017.04.009","article-title":"The 2010 ACR\/EULAR criteria are not sufficiently accurate in the early identification of autoantibody-negative rheumatoid arthritis: results from the Leiden-EAC and ESPOIR cohorts","volume":"47","author":"Boeters","year":"2017","journal-title":"Semin Arthritis Rheum"},{"key":"2025090312425911000_8.2.e002383.42","first-page":"37","article-title":"Does early seronegative arthritis develop into rheumatoid arthritis? 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